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CARDIOVASCULAR SYSTEM › LIPID MODIFYING AGENTS › LIPID MODIFYING AGENTS, COMBINATIONS › Lipid modifying agents in combination with other drugs
rosuvastatin and ramipril
C10BX17
Forms & Strengths
- Rosuvastatin/Ramipril 5mg/2.5mg capsule
- Rosuvastatin/Ramipril 5mg/5mg capsule
- Rosuvastatin/Ramipril 5mg/10mg capsule
- Rosuvastatin/Ramipril 10mg/2.5mg capsule
- Rosuvastatin/Ramipril 10mg/5mg capsule
- Rosuvastatin/Ramipril 10mg/10mg capsule
Adult Dosing
- Hypertension and dyslipidemia: One capsule once daily, individualized based on component titration and target goals
- Max recommended daily dose: Rosuvastatin 40mg / Ramipril 10mg
Pediatric Dosing
- Safety and efficacy not established in pediatric patients; combination product not recommended
Indications
- Primary hypercholesterolemia or mixed dyslipidemia
- Reduction of cardiovascular morbidity and mortality in patients with hypertension and dyslipidemia at high cardiovascular risk
Mechanism of Action
- Rosuvastatin: Selective and competitive inhibitor of HMG-CoA reductase, halting the rate-limiting step in hepatic cholesterol synthesis and upregulating LDL receptors
- Ramipril: ACE inhibitor that prevents the conversion of angiotensin I to angiotensin II, leading to decreased vasoconstriction, reduced aldosterone secretion, and decreased degradation of bradykinin
Contraindications
- Hypersensitivity to rosuvastatin, ramipril, or any ACE inhibitor
- History of angioedema related to previous ACE inhibitor or ARB therapy
- Hereditary or idiopathic angioedema
- Active liver disease or unexplained persistent elevations of serum transaminases
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment (eGFR < 60 mL/min/1.73m2)
- Pregnancy and lactation
Adverse Reactions
- Myalgia, arthralgia, and increased creatine kinase
- Persistent dry cough related to ACE inhibition
- Hypotension, dizziness, and headache
- Hyperkalemia and renal function impairment
- Angioedema (rare but severe)
- Elevated liver transaminases
Drug Interactions
- Cyclosporine: Significantly increases rosuvastatin exposure
- Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium: Increased risk of hyperkalemia
- Lithium: Decreased lithium clearance leading to potential toxicity
- NSAIDs: May attenuate the antihypertensive effect of ramipril and increase risk of renal impairment
- Coumarin anticoagulants: May potentiate INR response
Curated Content: Needs Vetting Before Put to Clinical Use